精德口腔財(cái)富門(mén)診初診滿意度調(diào)查問(wèn)卷

為了給您提供更好的服務(wù)，希望您能抽出2分鐘時(shí)間，將您的感受和建議告訴我們，我們非常重視每位客人的寶貴意見(jiàn)，期待您的參與～
1. 您選擇在精德口腔就診的原因是？（可多選）

Why did you choose to have dental treatment at JD Dental Clinic? (Multiple selections allowed)

2. 您本次來(lái)就診的主訴需求是：（可多選）

What is your primary reason for visit? (Multiple selections allowed) 

3. 您對(duì)本次就診的接診醫(yī)生及治療結(jié)果是否滿意？

Are you satisfied with the dentist and treatment he carried of this visit?

1為非常不滿意10為非常滿意

1 = Very dissatisfied; 10 = Very satisfied

4. 為了更好的提供診療服務(wù)，請(qǐng)您為醫(yī)生提出改進(jìn)的建議

Any suggestion for the dentist to provide better treatment services?

5. 您對(duì)本次就診的護(hù)士\醫(yī)生助理的服務(wù)是否滿意？
Are you satisfied with the service provided by the nurses/dentist’s assistants during this visit? 
1為非常不滿意10為非常滿意

 1 = Very Dissatisfied 10 = Very Satisfied

6. 為了更好的提供診療服務(wù)，請(qǐng)您為醫(yī)生助理/護(hù)士提出改進(jìn)的建議

Any suggestion for the nurses/dentist’s assistants to provide better treatment services?

7. 您對(duì)本次就診的前臺(tái)服務(wù)是否滿意？

Are you satisfied with the front desk service during this visit?

1為非常不滿意10為非常滿意
1 = Very Dissatisfied 10 = Very Satisfied
8. 為了更好的提供診療服務(wù)，請(qǐng)您為前臺(tái)人員提出改進(jìn)的建議
Any suggestion for the front desk staff to provide better services?
9. 您是否愿意向親友推薦我們門(mén)診？
Would you recommend our clinic to friends and family? 
1為非常不愿意10為非常愿意

 1 = No 10. Very willing

10. 不推薦的原因
Reasons for not recommending
11. 您對(duì)精德口腔有哪些意見(jiàn)和建議？

Any other suggestion for our Clinic?

12. 請(qǐng)您對(duì)本次就診體驗(yàn)做出評(píng)價(jià)

Please rate your experience of this visit: 1 for very dissatisfied, 10 for very satisfied

13. 本次就診醫(yī)師為

The dentist that carried the treatment for you this time was...

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